Category: Statistics

Circ Res. 2022 Dec 28. doi: 10.1161/CIRCRESAHA.122.321975. Online ahead of print.

ABSTRACT

BACKGROUND: Dysbiosis of gut microbiota plays a pivotal role in vascular dysfunction and microbial diversity was reported to be inversely correlated with arterial stiffness. However, the causal role of gut microbiota in the progression of arterial stiffness and the specific species along with the molecular mechanisms underlying this change remain largely unknown.

METHODS: Participants with elevated arterial stiffness and normal controls free of medication were matched for age and sex. The microbial composition and metabolic capacities between the 2 groups were compared with the integration of metagenomics and metabolomics. Subsequently, AngII (angiotensin II)-induced and humanized mouse model were employed to evaluate the protective effect of Flavonifractor plautii (F. plautii) and its main effector cis-aconitic acid.

RESULTS: Human fecal metagenomic sequencing revealed a significantly high abundance and centrality of F. plautii in normal controls, which was absent in the microbial community of subjects with elevated arterial stiffness. Moreover, blood pressure only mediated part of the effect of F. plautii on lower arterial stiffness. The microbiome of normal controls exhibited an enhanced capacity for glycolysis and polysaccharide degradation, whereas, those of subjects with increased arterial stiffness were characterized by increased biosynthesis of fatty acids and aromatic amino acids. Integrative analysis with metabolomics profiling further suggested that increased cis-aconitic acid served as the main effector for the protective effect of F. plautii against arterial stiffness. Replenishment with F. plautii and cis-aconitic acid improved elastic fiber network and reversed increased pulse wave velocity through the suppression of MMP-2 (matrix metalloproteinase-2) and inhibition of MCP-1 (monocyte chemoattractant protein-1) and NF-κB (nuclear factor kappa-B) activation in both AngII-induced and humanized model of arterial stiffness.

CONCLUSIONS: Our translational study identifies a novel link between F. plautii and arterial function and raises the possibility of sustaining vascular health by targeting gut microbiota.

PMID:36575982 | DOI:10.1161/CIRCRESAHA.122.321975

Neurorehabil Neural Repair. 2022 Dec 28:15459683221143461. doi: 10.1177/15459683221143461. Online ahead of print.

ABSTRACT

The Critical Periods After Stroke Study (CPASS, n = 72) showed that, compared to controls, an additional 20 hours of intensive upper limb therapy led to variable gains on the Action Research Arm Test depending on when therapy was started post-stroke: the subacute group (2-3 months) improved beyond the minimal clinically important difference and the acute group (0-1 month) showed smaller but statistically significant improvement, but the chronic group (6-9 months) did not demonstrate improvement that reached significance. Some have misinterpreted CPASS results to indicate that all inpatient motor therapy should be shifted to outpatient therapy delivered 2 to 3 months post-stroke. Instead, however, CPASS argues for a large dose of motor therapy delivered continuously and cumulatively during the acute and subacute phases. When interpreting trials like CPASS, one must consider the substantial dose of early usual customary care (UCC) motor therapy that all participants received. CPASS participants averaged 27.9 hours of UCC occupational therapy (OT) during the first 2 months and 9.8 hours of UCC OT during the third and fourth months post-stroke. Any recovery experienced would therefore result not just from CPASS intensive motor therapy but the combined effects of experimental therapy plus UCC. Statistical limitations also did not allow direct comparisons of the acute and subacute group outcomes in CPASS. Instead of shifting inpatient therapy hours to the subacute phase, CPASS argues for preserving inpatient UCC. We also recommend conducting multi-site dosing trials to determine whether additional intensive motor therapy delivered in the first 2 to 3 months following inpatient rehabilitation can further improve outcomes.

PMID:36575958 | DOI:10.1177/15459683221143461

J Appl Lab Med. 2022 Dec 28:jfac089. doi: 10.1093/jalm/jfac089. Online ahead of print.

ABSTRACT

BACKGROUND: Kidney stones are a highly prevalent disease worldwide. Additionally, both environmental and occupational exposure to Pb and Cd continue to be prevalent globally and can result in renal toxicity. The objective of this study was to examine the potential presence of Pb and Cd in kidney stones, and to assess for correlation with demographic factors including smoking, gender, age, and kidney stone matrix composition.

METHODS: Patient kidney stones (n = 96) were analyzed using Fourier transform infrared spectroscopy to identify the stone constituents. Cd and Pb concentrations (µg/g) were determined by inductively coupled plasma mass spectrometry. Cd and Pb concentrations were correlated using bivariable and multivariable statistical analysis with demographic factors (age, gender, smoking status), and kidney stone composition.

RESULTS: Kidney stone Cd (median 0.092 µg/g, range 0.014 to 2.46) and Pb concentrations (median 0.95 µg/g, range 0.060 to 15.4) were moderately correlated (r = 0.56, P < 0.0001). Cd concentrations were positively associated with patient history of smoking, patient age, and calcium oxalate monohydrate levels while negatively associated with struvite and uric acid/uric acid dihydrate. Pb concentrations were positively associated with females and apatite levels while negatively associated with uric acid/uric acid dihydrate. After holding constant other stone type composition levels, smoking status, and age, both Pb and Cd were positively associated with apatite and negatively associated with uric acid/uric acid dihydrate, struvite, and calcium carbonate.

CONCLUSIONS: Cd and Pb kidney stone concentrations are associated with specific kidney stone types. Cd and Pb kidney stone concentrations are both associated with smoking.

PMID:36575923 | DOI:10.1093/jalm/jfac089

Pediatrics. 2022 Dec 28:e2022059540. doi: 10.1542/peds.2022-059540. Online ahead of print.

NO ABSTRACT

PMID:36575920 | DOI:10.1542/peds.2022-059540

J Periodontal Res. 2022 Dec 27. doi: 10.1111/jre.13087. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aimed to evaluate the level of ADMA (asymmetric dimethylarginine), SDMA (symmetric dimethylarginine), and IL-1β (Interleukin-1β) in gingival crevicular fluid (GCF) from periodontitis patients and control subjects.

BACKGROUND: ADMA and SDMA are potentially hazardous non-proteinogenic amino acids that limit nitric oxide (NO) synthesis and have many functions in various human disorders. ADMA causes a structural change in nitric oxide synthase, while SDMA blocks arginine cell uptake. Increased plasma ADMA has been widely recognized as a “trigger” initiating impaired NO bioavailability and vascular dysfunction, which ultimately leads to oxidative stress.

METHODS: Twenty-five patients with periodontitis (P) (Stage III, Grade C, n = 25) and 20 control (C) subjects were included in the study. The IL-1β level of GCF was measured by enzyme immunoassay (ELISA) and ADMA and SDMA by liquid chromatography-mass spectrometry (LC-MS/MS).

RESULTS: Periodontitis patients had higher clinical parameters than controls (p < .001). Levels of IL-1β, ADMA and SDMA GCF were statistically significantly higher in group P than in group C (respectively; p = .003, p < .0001, p < .0001). There was no difference in the ADMA/SDMA ratio (p = .312) between the groups. There were significant positive correlations between clinical periodontal parameters and IL-1β, ADMA, and SDMA levels (p < .05). ADMA and SDMA levels were significantly correlated with IL-1β (p < .05).

CONCLUSIONS: These findings suggest that ADMA and SDMA may be involved in the pathogenesis of the periodontal disease.

PMID:36575915 | DOI:10.1111/jre.13087

Biotechnol Appl Biochem. 2022 Dec 27. doi: 10.1002/bab.2433. Online ahead of print.

ABSTRACT

Invasive infections caused by methicillin-resistant Staphylococcus aureus (MRSA) are associated with high mortality and morbidity. The sooner the pathogen is determined, the better it is beneficial to patient. However, routine laboratory inspections are time-consuming and laborious. A thorough research was conducted in PubMed, Web of Science (until June 2021) to identify studies evaluating the accuracy of MRSA identification by MALDI-TOF-MS. STATA 15.0 software was used to analyze the pooled results of sensitivity, specificity and 95% confidence intervals (CI). The summary receiver operating characteristic curves (SROC) and area under the curve (AUC) were utilized to show the overall performance of MALDI-TOF-MS. Fifteen studies involving 2,471 isolates were included in this study after the final selection in this meta-analysis. Using the random effects model forest plot to summarize the overall statistics, the sensitivity of MALDI-TOF MS for identifying MRSA was 92% (95% CI, 81%-97%), and the specificity was 97% (95% CI, 89%-99%). In the SROC curve, the AUC reached 0.99 (95% CI, 97%-99%). Deeks’ test showed no significant publication bias in this meta-analysis. Compared with clinical reference methods, MALDI-TOF MS identification of MRSA shows a higher degree of sensitivity and specificity. This article is protected by copyright. All rights reserved.

PMID:36575908 | DOI:10.1002/bab.2433

J Adv Nurs. 2022 Dec 27. doi: 10.1111/jan.15557. Online ahead of print.

ABSTRACT

AIM: To develop an emotional intelligence (EI) test and evaluate its psychometrics for social and healthcare student selection.

DESIGN: A cross-sectional methodological design.

METHODS: The test was developed based on a systematic review and focus group interviews. Content validity was evaluated with expert panels, and preliminary psychometrics with two pilot studies. Descriptive statistics, correlations and item response theory were used.

DATA SOURCES: Search was conducted in six databases 2018. Focus group interviews were conducted with educators and professionals in 2019. Expert panels with doctoral students, researchers and educators were conducted in 2020. Pilot tests with students were conducted 2020-2021. The developed test was administered to 4808 applicants 2021.

RESULTS: The test included four subscales. Correlations support the test’s theoretical structure. The items were mainly easy.

CONCLUSION: The test assesses EI objectively and comprehensively. The item-level distractor analysis can be used for further test development.

IMPACTS: Social care and healthcare students engage in clinical practice early in their studies, and these environments can be emotionally challenging. Assessing EI in student selection with adequate test can help the institutions of higher education to select the students with required abilities to succeed in the studies. The assessment of EI during student selection also provides information higher education institutions could use to develop and provide support interventions. The results may also encourage practice placements to include EI elements as learning objective. The results of this study and especially the use of IRT and detailed distractor analysis to evaluate the psychometric properties of EMI-T can benefit researchers and educators that develop or evaluate objective assessment tools with multiple choice questions.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Emotional intelligence is important for students to enable professional interaction.

PMID:36575904 | DOI:10.1111/jan.15557

J Cosmet Dermatol. 2022 Dec 27. doi: 10.1111/jocd.15570. Online ahead of print.

ABSTRACT

PURPOSE: After the emergence of the pandemic caused by the COVID-19 virus, vaccination with various vaccines has started to be implemented across the world. To identify dermatological reactions developing after the COVID-19 vaccines administered in Turkey and determine their clinical features and risk factors that may play a role in their development.

MATERIALS AND METHODS: The study included patients aged ≥18 years, who presented to 13 different dermatology clinics in Turkey between July 2021 and September 2021 after developing dermatological reactions following the administration of the COVID-19 vaccine. After providing written consent, the patients were asked to complete a standard survey including questions related to age, gender, occupation, comorbidities, the regular medication used, the onset of cutaneous reactions after vaccination, and localization of reactions. Dermatological reactions were categorized according to whether they developed after the first or second dose of the vaccine or whether they occurred after the inactivated or messenger RNA (mRNA) vaccine. The relationship between dermatological reactions and some variables such as gender and comorbidities was also evaluated.

RESULTS: A total of 269 patients [116 women (43.1%), 153 men (56.9%)] were included in the study. It was observed that the dermatological diseases and reactions that most frequently developed after vaccination were urticaria (25.7%), herpes zoster (24.9%), maculopapular eruption (12.3%), and pityriasis rosea (4.5%). The rate of dermatological reactions was 60.6% after the administration of the mRNA vaccine and 39.4% after that of the inactivated vaccine. There was a statistically significantly higher number of reactions among the patients that received the mRNA vaccine (p = 0.001).

CONCLUSION: The most common reactions in our sample were urticaria, herpes zoster, and maculopapular eruption. Physicians should know the dermatological side effects of COVID-19 vaccines and their clinical features.

PMID:36575896 | DOI:10.1111/jocd.15570

J Cosmet Dermatol. 2022 Dec 27. doi: 10.1111/jocd.15558. Online ahead of print.

ABSTRACT

BACKGROUND: Alopecia areata (AA) is a common non-scarring hair loss disorder that affects children and adults with a great psychological burden because of its recurrent and sometimes treatment-refractory nature.

OBJECTIVE: To compare the efficacy of topical calcineurin inhibitor, topical potent steroid combined with vitamin D analogue versus topical superpotent steroid in treatment of localized AA.

PATIENTS AND METHODS: Sixty subjects with chronic (>1 year) localized (SALT score < 25%) AA, confirmed clinically and dermoscopically, were randomized into three groups. Group I used topical 0.03% tacrolimus (Tarolimus®), group II used topical potent steroid combined with vitamin D analogue (Daivobet®). and group III used topical superpotent steroid (Dermovate®). All patients continued a daily therapy for three successive months and were followed up for three other months. Assessment was done using PULL test, SALT score, and dermoscopic comparison before and after therapy.

RESULTS: Group II showed comparable statistical results to group III with lower values in a non-statistically significant way. Group I achieved the least improvement among all groups.

CONCLUSION: Combined vitamin D analogues with potent steroid appears to be a more convenient treatment for localized AA than superpotent steroids because of less side effects and comparable efficacy. Tacrolimus needs further research or formula customization to be used as a topical therapy for AA.

PMID:36575890 | DOI:10.1111/jocd.15558

J Cosmet Dermatol. 2022 Dec 27. doi: 10.1111/jocd.15568. Online ahead of print.

ABSTRACT

BACKGROUND: The experience of pain during microfocused ultrasound with visualization (MFU-V) treatment is common and crucial for dictating patient satisfaction and retention.

OBJECTIVE: To compare the pain perception during the MFU-V procedure between two pain reduction methods (topical anesthesia alone versus combined topical anesthesia with forced air cooling).

MATERIALS AND METHODS: This was a prospective, single-blinded, randomized controlled trial. A square area on the inner side of both arms of healthy volunteers was marked as an experimental site and randomly assigned to receive each pain reduction method: topical anesthesia or combined topical anesthesia with forced air cooling. Thereafter, MFU-V was performed with a 4.5 MHz, 4.5 mm transducer (10 lines, 0.9 J) followed by a 7 MHz, 3.0 mm transducer (10 lines, 0.3 J). The visual analog scale (VAS) for pain was measured immediately after 4.5 mm transducer (T1a), immediately after 3.0 mm transducer (T1b), and after the entire procedure (T2).

RESULTS: Twenty-one participants with a mean (SD) age of 34.67 (±6.18) years were enrolled. The mean (±SD) pain score of combined topical anesthesia with forced air cooling-treated area was 5.40 (±1.64), 4.80 (±1.63), and 5.40 (±1.56) at T1a, T1b, and T2, respectively. The mean pain score for topical anesthesia-treated areas was 5.89 (±1.45), 5.00 (±1.72), and 5.76 (±1.67) at T1a, T1b, and T2, respectively. There were no statistically significant differences in the pain perception between the two methods.

CONCLUSION: The addition of forced air cooling is not beneficial for pain reduction during the MFU-V procedure because its temperature reduction effect cannot be delivered to the deep parts of the skin, which is the target site of MFU-V.

PMID:36575874 | DOI:10.1111/jocd.15568